Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANC BON CHP 4 030400300

Facility

$2,175.00

Hospital Charge Code	270639514
Hospital Revenue Code	272
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$326.25
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

CANCELLOUS 4.0MM X 16MM

Facility

$330.00

Hospital Charge Code	270657763
Hospital Revenue Code	278
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$79.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

CANCELLOUS 4.0MM X 16MM

Facility

$330.00

Hospital Charge Code	270657763
Hospital Revenue Code	278
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

CANCELLOUS CHIPS CRUSHED 15 CC

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270700443
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

CANCELLOUS CHIPS CRUSHED 15 CC

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270700443
Hospital Revenue Code	278
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$52.42
Rate for Payer: Wellpoint Medicaid Managed Care	$57.64

CANCELLOUS MORSELIZED 5CC

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684819
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CANCELLOUS MORSELIZED 5CC

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684819
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

CANCELLOUS SCREW

Facility

$145.00

Hospital Charge Code	270656417
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

CANCELLOUS SCREW

Facility

$145.00

Hospital Charge Code	270656417
Hospital Revenue Code	278
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

CANCER ANTIGEN 125 (CA125)

Facility

$602.00

Service Code	HCPCS 86304
Hospital Charge Code	38472156
Hospital Revenue Code	302
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

CANCER ANTIGEN 125 (CA125)

Facility

$602.00

Service Code	HCPCS 86304
Hospital Charge Code	38472156
Hospital Revenue Code	302
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

CANCER ANTIGEN 15-3 (CA 15-3)

Facility

$602.00

Service Code	HCPCS 86300
Hospital Charge Code	38476214
Hospital Revenue Code	302
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

CANCER ANTIGEN 15-3 (CA 15-3)

Facility

$602.00

Service Code	HCPCS 86300
Hospital Charge Code	38476214
Hospital Revenue Code	302
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

CANCER ANTIGEN 19-9 (CA 19-9)

Facility

$402.00

Service Code	HCPCS 86301
Hospital Charge Code	38476215
Hospital Revenue Code	302
Min. Negotiated Rate	$60.30
Max. Negotiated Rate	$60.30
Rate for Payer: Qualcare PPO/HMO/WC	$60.30

CANCER ANTIGEN 19-9 (CA 19-9)

Facility

$402.00

Service Code	HCPCS 86301
Hospital Charge Code	38476215
Hospital Revenue Code	302
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$201.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$201.00
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

Cancer Antigen (CA) 125, Serum

Facility

$667.59

Service Code	HCPCS 86304
Hospital Charge Code	39888021
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Cancer Antigen (CA) 125, Serum

Facility

$667.59

Service Code	HCPCS 86304
Hospital Charge Code	39888021
Hospital Revenue Code	302
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

CANCER SCREEN PSA

Facility

$130.29

Service Code	HCPCS 84152
Hospital Charge Code	38477153
Hospital Revenue Code	300
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.02
Rate for Payer: Aetna Medicare Advantage	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.38
Rate for Payer: Cigna Commercial	$65.14
Rate for Payer: Cigna Medicare Advantage	$18.39
Rate for Payer: Clover Medicare Advantage	$17.47
Rate for Payer: EmblemHealth Commercial	$55.17
Rate for Payer: Humana Medicare Advantage	$18.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.39
Rate for Payer: Wellcare Medicare Advantage	$18.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.45

CANCER SCREEN PSA

Facility

$130.29

Service Code	HCPCS 84152
Hospital Charge Code	38477153
Hospital Revenue Code	300
Min. Negotiated Rate	$19.54
Max. Negotiated Rate	$19.54
Rate for Payer: Qualcare PPO/HMO/WC	$19.54

CANCIDAS 50 MG INJ

Facility

$1,147.00

Hospital Charge Code	60635336
Hospital Revenue Code	636
Min. Negotiated Rate	$27.64
Max. Negotiated Rate	$573.50
Rate for Payer: Aetna Commercial	$435.86
Rate for Payer: Aetna Medicare Advantage	$344.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.49
Rate for Payer: Cigna Commercial	$573.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.57
Rate for Payer: Qualcare PPO/HMO/WC	$172.05
Rate for Payer: UnitedHealthcare Community & State	$27.64
Rate for Payer: Wellpoint Medicaid Managed Care	$30.40

CANCIDAS 50 MG INJ

Facility

$1,147.00

Hospital Charge Code	60635336
Hospital Revenue Code	636
Min. Negotiated Rate	$172.05
Max. Negotiated Rate	$277.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.57
Rate for Payer: Qualcare PPO/HMO/WC	$172.05

CANCIDAS 70 MG INJ

Facility

$1,328.00

Hospital Charge Code	60635335
Hospital Revenue Code	636
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$664.00
Rate for Payer: Aetna Commercial	$504.64
Rate for Payer: Aetna Medicare Advantage	$398.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$338.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$338.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$338.64
Rate for Payer: Cigna Commercial	$664.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.38
Rate for Payer: Qualcare PPO/HMO/WC	$199.20
Rate for Payer: UnitedHealthcare Community & State	$32.00
Rate for Payer: Wellpoint Medicaid Managed Care	$35.19

CANCIDAS 70 MG INJ

Facility

$1,328.00

Hospital Charge Code	60635335
Hospital Revenue Code	636
Min. Negotiated Rate	$199.20
Max. Negotiated Rate	$321.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.38
Rate for Payer: Qualcare PPO/HMO/WC	$199.20

CANDESARTAN 16 MG TAB

Facility

$11.25

Hospital Charge Code	60628916
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

CANDESARTAN 16 MG TAB

Facility

$11.25

Hospital Charge Code	60628916
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

Know your out-of-pocket cost for care.

All Charges